The risks of alcohol are directly related to the amount of alcohol consumed and the time period over which it is used. Individual sensitivity and associated nutritional balance, supplements, allergy, and lifestyle factors also contribute to the specific problems that may result from alcohol. Empirically, high risk may be assumed to be posed by more than five drinks daily; moderate risk by three to five drinks daily; and low risk by one or two drinks daily. Social drinking of one or two drinks a week is considered light use.

Given the general liberal viewpoint regarding low-level alcohol consumption that prevails in common medical literature, I should clarify who should not drink. Clearly, people with diabetes, hypertension, or heart disease and pregnant or nursing mothers (and those planning pregnancy) should avoid alcohol completely. People with hypoglycemic problems, liver disorders, especially hepatitis, viral diseases, candidiasis, mental confusion, fatigue, or hypersensitive reactions to alcoholic beverages should also avoid it.

. These include dryness of mouth, thirst, headache (throbbing temples are common), nausea, vomiting, stomach upset, fatigue, and dizziness. Alcohol dehydrates the cells, removes fluid from the blood, swells the cranial arteries, and irritates the gastrointestinal tract. Hangovers are more common with distilled, stronger alcohol drinks and less so with red wine, champagne, white wine, and beer. One theory is that the hangover is primarily an effect of the chemical congeners produced through the formation of fermentation by-products and the many chemicals used in growing the foods and manufacturing the beverages, although no chemicals (even food dyes) need be listed on a label.

. It has become clear that alcohol abuse affects others through the actions of the abuser, causing innocent people to be injured and killed. Alcohol is responsible for more than 25,000 deaths a year from auto accidents, about half of all driver deaths and about one-third of pedestrian mortalities. About 20 percent of home accidental deaths are also attributed to alcohol, as are many falls and drownings. Other drugs may also be involved in these accidents and injuries, but alcohol is by far the most common culprit. The suppressant action of alcohol also reduces self-control, judgment, and usual moral sense. Drunk people act out their aggressions, often on their loved ones or strangers as well as themselves. Alcoholics have higher than average suicide rates. The weakened adrenal response from alcohol makes us less able to handle stress. With the growing awareness of the menacing qualities of alcohol, more stringent laws are being enacted to prosecute drunk drivers, and jail is usually good negative feedback for changing alcohol abuse. However, this alone may not correct or cure this common disease.

Liver disease

. Alcohol irritates the liver, raising the liver enzyme levels and leading to hepatitis (liver inflammation). Remember, 95 percent of alcohol consumed must be metabolized in the liver; this process requires a lot of work and takes precedence over many other necessary functions. Fat metabolism is decreased, and fatty buildup can occur in the liver. Alcohol converts to fat, not to glucose or glycogen. Obesity also occurs with high alcohol use. With chronic use, fat continues to be stored in and irritate the liver, which eventually swells, scars, and shrinks (the process of cirrhosis) until only a small percentage is functional. Usually more than half the liver must be destroyed before its work is significantly impaired. Advanced liver disease leads to all kinds of complications, including ascites, a fluid buildup in the abdomen. Still, since the liver is our most regenerative organ, stopping drinking will usually allow for recovery. Hemorrhoids and varicose veins are commonly a result of liver disease in alcoholics. Thiamine (B1), and niacinamide (B3) help the liver detoxify alcohol, so if body levels of these are low, the liver may be more sensitive to inflammation.

Stomach disorders—gastritis and ulcers

. Alcohol irritates and injures the mucosal lining of the upper gastrointestinal tract, including the esophagus, stomach, and upper small intestine. It also increases hydrochloric acid production. This combination, along with poor nutritional protection, often leads to stomach inflammation —that is, gastritis—associated with abdominal pain and difficulty in eating. Both gastric and duodenal ulcers are found with increased frequency in alcoholics. A reduction in digestive enzymes needed to break down foods and alkalize the gastrointestinal tract causes irritating acid fluids to go further down the tube and affect the intestinal mucosa. This can lead to the "leaky gut syndrome," which allows larger, incompletely digested molecules to be absorbed and generates more food allergic reaction. The irritation of the esophagus can cause a painful esophagitis. Dilated (varicose) veins also can occur there because of liver circulation back up, and these can rupture, creating a medical emergency.

Pancreatitis and gallstones

. Inflammation of the pancreas is a painful problem that is thought to be caused by alcohol irritation in certain individuals. There are likely other factors contributing to this problem. Gallbladder disease and gallstones are also probably caused by a number of factors, including alcohol irritation, poor fat utilization, and improper nutrient metabolism.

Nervous system disorders

. Alcohol crosses the blood-brain barrier and directly affects the brain. It can actually destroy brain cells, leading to brain damage as well as behavior and psychological problems. Chronic use of alcohol, probably with associated B vitamin deficiencies, may lead to painful nerve inflammations called polyneuritis. Premature senility occurs with alcohol abuse, as does a chronic degenerative brain syndrome, termed encephalopathy.

Cardiovascular disease

. Although it appears that a small amount of alcohol may raise HDL cholesterol and protect against atherosclerosis, the overall effect of alcohol abuse is deadly to the heart and blood vessels. The blood pressure is elevated, which increases cardiovascular risk. Lipid metabolism is affected, which increases triglyceride levels, which in turn raises blood cholesterol. With the familial hyperlipidemia disorders, this alcohol influence can be worse. Alcohol also reduces the essential fatty acid and protective prostaglandin levels; this further sensitizes the cardiovascular system. Heart function, heart muscle action, and electrical conductivity in the heart are all decreased with alcohol. This can lead to heart disease, congestive heart failure, and cardiac arrhythmias. Cardiomyopathy, or enlarged heart, with poor function has been associated with alcohol and some ingredients in the beverages, such as cobalt.

Carbohydrate metabolism

—hypoglycemia and diabetes. Since alcohol is a simple sugar that is rapidly absorbed and utilized, and affects the digestion as well as liver and pancreatic functions, it has a tendency to weaken glucose tolerance with chronic use. The incidence of both hypoglycemia and diabetes is higher with alcohol abuse. Blood sugar problems are generally more frequent with regular use of alcohol. The poor blood sugar utilization can affect the nerve and liver health as well.

Nutritional excesses—obesity

. An increase in alcohol calories that specifically turn into fat will lead to weight gain and more body fat unless it is balanced by exercise and a good diet. Many athletes drink excessively and can handle alcohol better than the less active person; when exercise is reduced, however, there is more concern. Also, with regular alcohol use, there is much more danger of nutrient deficiencies.

Nutritional deficiencies.

Alcohol can interfere with a number of functions related to the metabolism of nutrients. In addition to the poor intake of food nutrients common with alcohol abuse, alcohol impairs digestion and absorption of many nutrients from the small intestine. These include most B vitamins, such as B1, B6, B12, choline and folic acid, as well as some minerals; and with liver impairment absorption of the fat-soluble vitamins A, D, E, and K is also reduced. Alcohol’s diuretic effect can lead to the loss of nutrients and create dehydration as well. Alcohol also uses nutrients that it does not provide for its own metabolism, impairs the metabolism of many others, and reduces liver stores of even more. For example, vitamins B1 and B3 are needed by the liver to metabolize alcohol, and these are often in short supply. Folic acid’s function in the bone marrow, where it helps make red blood cells, is diminished by alcohol. Thus, anemia may develop more easily with alcohol abuse, especially with low levels of vitamin B12 and reduced absorption and storage of iron. The low vitamin D availability and poor calcium absorption can lead to an increased risk of osteoporosis. The loss of many minerals, such as zinc and magnesium, increases even more with caffeine use. The lack of appetite caused by alcohol abuse also makes it harder to get needed nutrients. In the elderly, where nutritional status is often unstable and alcohol consumption a problem, nutritional deficits can be exacerbated. Alcoholism in all ages is commonly associated with malnutrition. Other nutrients commonly deficient with alcohol abuse include vitamins B2, B6, A, and C, essential fatty acids, and methionine.

Low sexuality and impotence.

Alcohol increases levels of the liver enzyme that breaks down testosterone, a hormone that stimulates sexuality. Alcohol’s depressant effect on the nervous system can also reduce a man’s ability to perform, although it may reduce inhibitions and increase his desires. In teenage boys, the reduction of testosterone may delay sexual maturity. In later life, alcohol abuse is more commonly associated with impotence.

Cancer factor.

Alcohol is probably a cofactor in cancer development and is implicated in malignancy of the mouth, esophagus, pancreas, and breast. All of these cancers are even more likely to occur when alcohol abuse is combined with cigarette smoking. One theory is that cigarette smoke and alcohol together chemically create ethyl nitrite, which is a mutagen. Cancer rates are higher in heavy drinkers than in more moderate ones. Nutritional deficiencies likely play a role as well.

Birth defects.

Alcohol can be a definite problem for the fetus, a fact that seemed to be acknowledged thousands of years ago, but had been forgotten for awhile. Alcohol crosses the placenta and gets into the fetal circulation, where it cannot be handled metabolically because of undeveloped liver function, so it is more toxic. The fetal alcohol syndrome recently described is associated with undersized babies with small facial features and mental deficits due to brain damage. To some authorities, limiting consumption to less than two drinks daily is enough to prevent this problem; to most others, there is no safe level—women simply should not drink while pregnant! Even one to two drinks a day in the first trimester can lead to retarded growth and mental development. Since alcohol has this influence on the fetus even during the first couple of months, a woman who is planning to become pregnant or even open to the possibility should avoid or at least limit (one drink only) alcohol intake. For the mother-to-be, who needs to be very well nourished to handle pregnancy, alcohol is an added stress, irritant, and nutritional drain. Alcohol also gets into the breast milk, and this may adversely affect nursing babies, although not as seriously as when in utero. Nursing mothers are also better off without the depleting effects of alcohol.

Elson M. Haas, MD is founder & Director of the Preventive Medical Center of Marin (since 1984), an Integrated Health Care Facility in San Rafael, CA and author of many books on Health and Nutrition, including ...more

Disclaimer: The information provided on HealthWorld Online is for educational purposes only and IS NOT intended as a substitute for
professional medical advice, diagnosis, or treatment. Always seek professional medical advice from your physician or other qualified
healthcare provider with any questions you may have regarding a medical condition.

Are you ready to embark on a personal wellness journey with our whole person approach?